Individual provider Active NPI

Keylesha Susso, RCS, RVS

  • Sonography Specialist/Technologist Cardiovascular
  • Plano, TX
National Provider Identifier
1477023448
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sonography Specialist/Technologist CardiovascularTaxonomy code 246XS1301X
License
00080850 Issued in NC
Practice address
1705 Coit Rd Apt 1017
Plano, TX 75075-6146
Phone
(469) 968-2684
NPI assigned
Dec 3, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sonography Specialist/Technologist Cardiovascular 246XS1301X 00080850 NC Primary

Addresses

Primary practice location

1705 Coit Rd Apt 1017
Plano, TX 75075-6146

Mailing address

3000 Custer Rd Ste 270-464
Plano, TX 75075-4422
Phone (469) 968-2684

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
00080850NCMDSonography Specialist/Technologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1543795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1477023448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 CUSTER RD STE 270-464",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750754422",
            "telephone_number": "469-968-2684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 COIT RD APT 1017",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750756146",
            "telephone_number": "469-968-2684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSSO",
        "first_name": "KEYLESHA",
        "credential": "RCS, RVS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-03",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246XS1301X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist Cardiovascular, Sonography",
            "state": "NC",
            "license": "00080850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.